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Determinants of neonatal near-miss among neonates of postnatal women in north Wollo hospitals, northern Ethiopia, 2022.

Abebaw Alamrew*, Amare workie, Wondimnew Gashaw, Aynalem Yetwale, Lake Geremew, Getinet Kumie, Haimanot Hailu

Background: Children born with life-threatening conditions are more likely to die particularly during the neonatal period. Neonatal near-miss events are three to six times more frequent than neonatal deaths. However, there is limited evidence of this problem in sub-Saharan Africa, particularly Ethiopia. Therefore, this study aimed to identify the determinants of neonatal near misses among neonates delivered in public hospitals in the North Wollo Zone, Northern Ethiopia.

Methods: A facility-based unmatched case-control study was conducted from February 25 to April 25, 2022, on 453 participants. Consecutive and systematic sampling techniques were used. A pre-tested semi- structured intervieweradministered questionnaire and medical record review were used to collect the data. Data were entered using Epi Data Manager 4.6.6 and exported to SPSS version 26 for analysis. After performing bivariable logistic regression, variables with a p-value < 0.2 were entered into a multivariable logistic regression. Both Descriptive and inferential statistics were carried out, and finally, AOR together with 95% CI and p-value <0.05 were used to declare the significance of all statistics.

Result: The results showed that rural residents (AOR = 1.89, CI:1.05-3.39), no antenatal care follow-up (AOR = 4.77, CI:2.13-10.72), less than four antenatal care follow-ups (AOR =2.49, CI:1.13-5.49), birth interval of less than 2 years (AOR= 4.53, CI:2.32-8.83), pregnancy-induced hypertension (AOR=2.97, CI:1.35-6.48) and premature rupture of membranes (AOR= 2.94, CI:1.30-6.62) were determinants of neonatal near miss.

Conclusion: Rural residents, who did not have antenatal care follow-up, had fewer than four antenatal care follow-ups, birth intervals less than 2 years, pregnancy -induced hypertension, and premature rupture of membranes were determinants of neonatal near miss. Encouraging Antenatal care follow-up, adequate antenatal services, family planning utilization, and early screening and treatment of complications that occur during pregnancy is needed to improve neonatal health outcomes